When range of motion is not enough: Towards an evidence-based approach to medico-legal reporting in whiplash injury

•Chronicity rates following whiplash injury are high.•Traditional medical approaches to whiplash injury medico-legal reporting appear to have limited prognostic utility.•The claimant's psycho-physiological stress response to whiplash injury appears to play a key role in recovery.•Validated questionnaires and reliable physical examination approaches are suggested as key components of a contemporary approach.

Whiplash injury medico-legal reporting has traditionally been focused upon identifying restrictions in range of motion and identifying the presence of tender areas in the cervical spine in an effort both to diagnose the condition and to offer a prognosis. There have been considerable advances in this field over the last decade however that calls into question such a diminutive approach. This paper reviews the contemporary evidence base for the medico-legal assessment of whiplash injury and identifies a body of literature that strongly implicates a Claimant's physiological and psychological stress response as a key medico-legal marker in predicting prognosis following whiplash injury.